Duration of Medication for Opioid Use Disorder During Pregnancy and Postpartum by Race/Ethnicity: Results from 6 State Medicaid Programs

Authors

Anna E. Austin Department of Maternal and Child Health and Injury Prevention Research Center, University of North Carolina at Chapel Hill, United States; Injury Prevention Research Center, University of North Carolina at Chapel Hil
Christine Piette Durrance, La Follette School of Public Affairs, University of Wisconsin-Madison
Katherine A. Aherns MPH, PhD, Muskie School of Public Service, University of Southern Maine
Chen Qingwen, Department of Health Policy and Management, University of Pittsburgh
Lindsey Hammerslag, Institute for Biomedical Informatics, University of Kentucky
Mary Joan McDuffie, Center for Community Research & Service, Biden School of Public Policy and Administration, University of Delaware
Marian Jarlenski, School of Social Work, University of North Carolina at Chapel Hil

Document Type

Article

Publication Date

6-1-2023

Publication Title

Drug and Alcohol Dependence.

Keywords

Muskie, Faculty Scholarship, Inequity disparity; Medicaid; Medication for opioid use disorder; Postpartum; Pregnancy.

Abstract

Background: Medication for opioid use disorder (MOUD) is evidence-based treatment during pregnancy and postpartum. Prior studies show racial/ethnic differences in receipt of MOUD during pregnancy. Fewer studies have examined racial/ethnic differences in MOUD receipt and duration during the first year postpartum and in the type of MOUD received during pregnancy and postpartum.

Methods: We used Medicaid administrative data from 6 states to compare the percentage of women with any MOUD and the average proportion of days covered (PDC) with MOUD, overall and by type of MOUD, during pregnancy and four postpartum periods (1-90 days, 91-180 days, 181-270 days, and 271-360 days postpartum) among White non-Hispanic, Black non-Hispanic, and Hispanic women diagnosed with OUD.

Results: White non-Hispanic women were more likely to receive any MOUD during pregnancy and all postpartum periods compared to Hispanic and Black non-Hispanic women. For all MOUD types combined and for buprenorphine, White non-Hispanic women had the highest average PDC during pregnancy and each postpartum period, followed by Hispanic women and Black non-Hispanic women (e.g., for all MOUD types, 0.49 vs. 0.41 vs. 0.23 PDC, respectively, during days 1-90 postpartum). For methadone, White non-Hispanic and Hispanic women had similar average PDC during pregnancy and postpartum, and Black non-Hispanic women had substantially lower PDC.

Conclusions: There are stark racial/ethnic differences in MOUD during pregnancy and the first year postpartum. Reducing these inequities is critical to improving health outcomes among pregnant and postpartum women with OUD.

Recommended Citation

Austin, A. E., Durrance, C. P., Ahrens, K. A., Chen, Q., Hammerslag, L., McDuffie, M. J., Talbert, J., Lanier, P., Donohue, J. M., & Jarlenski, M. (2023). Duration of Medication for Opioid Use Disorder During Pregnancy and Postpartum by Race/Ethnicity: Results from 6 State Medicaid Programs. Drug and Alcohol Dependence. https://doi.org/https://odoi.org/10.1016/j.drugalcdep.2023.109868